Borderline Personality Disorder Chat Conference:

Guest Speaker:  Paul Markovitz M.D., Ph.D.  6/28/00

Page Two

Tim:

or do other disorders self mutilate?? 

Patty: 

If someone cuts, does that mean they have the borderline personality disorder "more severely," or does it meant that there are different "types" of BPD? 

Dr. Markovitz: 

Cutting usually indicates BPD. Surprisingly, it was the best predictor of a good outcome. You did better with it 

Christy:

What causes me not to even realize that I am cutting on myself until all is done? 

Bingle: 

what do you mean did better with cutting? 

Dr. Markovitz: 

You may depersonalize when you cut. Or maybe it just feels so good, you do it. Like scratching an itch. 

Lance: 

but I’m serious Dr. M. when I take heroin I don't feel anxious or different from others I have drive and I really feel normal like all my symptoms are gone and one little bag lasts for 2 or 3 days <Freaked> I burn to punish myself 

Dr. Markovitz: 

Cutters have the best outcome with medications by a ton. 

Freaked: 

and then pick and scratch at them when there healing to relive it. 

Patty

Very interesting. 

Bingle: 

so perhaps I should start cutting..lol 

Dr. Markovitz: 

As far as heroin, you might want to think about getting on a substance P antagonist when available. There are trials now 
Never cut if you can avoid it 

Weepippo: 

I take Serzone and Risperdol dr. wants to add Remeron will it put me tranquilized? 
<chameo> I spent 3 years in a lock up psyche ward waiting for meds to stop me cutting, burning, attempting to hang myself and nothing changed until I decided to stop without drugs 

Lance: 

I not hooked on it I do relapse every once in a while but I do it so I won't cut 

Dr. Markovitz: 

Novartis is running substance p trials in Europe and US 

Opalene:

[1]Is there any correlation between hyperthyroidism and BPD? 

Dr. Markovitz: 

No correlation between high thyroid and BPD. 

Ellie: 

I have been in therapy for five yrs, tried every anti-d, still cut myself and am not seeing any improvement. What am I doing wrong? 

Dr. Markovitz: 

High thyroid will make it worse 

Weepippo: 

I have hyper thyroid also op 

Opalene:

Doesn't the stress of BPD affect the thyroid. Type A personality does. 

Lance: 

I kind of feel if I raise the dopamine in my head I do alright 

Dr. Markovitz: 

ellie, you may not be on enough of the correct one. If you have access to Zoloft, get on 200 mg/day and have a level checked 6-8 hours after your am dose. If it is not 180 ng/ml or higher, you will break down all meds fast and need higher doses 
Dopamine increases are good for some. Wellbutrin, high dose Effexor, and Provigil do this 

Ellie: 

tried Zoloft....but will check that out. thanks 

Lance: 

this is wrong 

Chameo:

what lance? 

Lance: 

dopamine chameo 

Bingle: 

can you safely take more than 400mg Wellbutrin SR 

Dr. Markovitz: 

dopamine increase concentration and energy 

Bingle: 

wellbutrin sr 

Dr. Markovitz: 

I would be careful about higher doses of Wellbutrin. Check with your doctor. Can cause seizures 

Lance: 

so I can do that without heroin 

Chameo:

so doc do you reckon no matter how much more work I do on myself the mood swings will never go 

Dr. Markovitz: 

I hope. It is worth a try 
Heroin is bad 

Lance: 

I know 
but I don't know how else to cope sometimes 

Dr. Markovitz: 

Mood swings will never leave without correct med 

Chameo:

so what’s the point then 

Dr. Markovitz: 

the correct thing to do is get better. Illegal things are illegal for a reason 

Bingle: 

when they leave will they stay away or will I need to take meds for rest of my life 
Moods I mean 

Patty:

I think the Dr. is trying to say that if we can find the right meds., our BPD symptoms can be reduced. 

Dr. Markovitz: 

meds forever. Like diabetes. May have a cure in 10-15 years with the DNA projects ongoing 

Weepippo: 

so we are biological freaks on terminal paths eased only by medication? 

Chameo:

this is pants 

Woodsey:

chameo the problem with the nhs is it wont fund the new drugs 

VicHam:

any pts. of yours have alopecia w/hi dose Effexor? I did at 150 mg 

Dr. Markovitz: 

no. I have diabetes and I do not think I am a freak. It is just the way it is biologically. I would be a jerk not to get better or as w2ell as I can 

Freaked: 

SO WILL WE NEED TO BE ON MEDS FOR THE REST OF OUR LIVES? 

Chameo:

I cant go thru these feelings again 

Dr. Markovitz: 

yes freaked 
Effexor and alopecia is new to me. 

VicHam:

could of been my vitiligo? 

Dr. Markovitz: 

If you have used heroin and you are not better, doing the same thing again will not help any more than in the past 

Freaked: 

can I ask an extremely important question? 

Tim:

I've have been on meds since I was 13 its just a state of being for me. I know I need medication or else 

Lance: 

how high can I go on Effexor?

Ellie: 

yes freaked, ask 

Chameo:

all the drugs make me fat 

Tim:

Or I can self medicate with alcohol to make me feel "normal" 

Patty:

Freaked, I have to take thyroid meds the rest of my life due to hypothyroidism. Taking a pill in the morning does not bother me in the least. It is *ok* to take meds the rest of our lives. 

Ellie: 

me too chameo 

Freaked: 

ok I want to adopt my step girls....will me being borderline personality disorder on meds forever affect the court's decision? 

Bingle: 

its ok but when you have more than 1 problem that you need meds for the rest of your life for is sort of depressing. 

Freaked: 

will I lose custody because of this shitty disease? 

Dr. Markovitz: 

lance, you can go up to any dose, but it usually works between 300 and 600 mg 

VicHam:

bald spots stopped after I stopped taking Effexor 
two yrs ago 

Dr. Markovitz: 

sorry. Perhaps another med will work 

Freaked: 

sorry it's not the same kind of questions people are asking :o( 

Weepippo:

yes drugs are excepted in society for physical reasons not mental 

Dr. Markovitz: 

mental is physical. It is just a physical reaction in your brain 

Freaked: 

CAN SOMEONE ANSWER MY QUESTION? 

Tim:

Freak, questions like that are for the courts. Its up to a judge 

Ellie: 

I can answer what I think will happen, but that doesn't mean squat. :/ 

Tim:

Its better to show your getting treatment 

Patty:

Dr., besides taking meds which is vital, are there some other tips for us to help us? Are there things we should avoid, etc. 

Dr. Markovitz: 

If you eat carbohydrates, use complex ones 

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